李文思 苏雷

【摘要】 目的：探讨肺腺癌临床病理特征与表皮生长因子（EGFR）基因突变的关系。方法：选择2017年5月-2018年5月本院收治的120例肺腺癌患者为研究对象，采用单因素分析和多元logistic回归模型分析肺腺癌临床病理特征与EGFR基因突变的关系。结果：120例肺腺癌患者中，EGFR基因突变的有76例。男性、有吸烟史及浸润性癌变体者的EGFR基因突变率明显低于女性、无吸烟史及浸润性癌者（P<0.05）。不同TNM分期及病理类型者的EFGR突变率比较，差异均无统计学意义（P>0.05）。多元logistic回归分析结果显示，性别、吸烟史及组织亚型与肺腺癌EGFR基因突变有关（P<0.05）。浸润性肺癌EGFR基因突变者中腺泡型占比最高（56.3%）。结论：肺腺癌患者中EGFR基因突变与性别、吸烟史及组织学亚型有关，且浸润性肺腺癌EGFR基因突变者中腺泡型占比最高。

【关键词】 肺腺癌 EGFR 基因突变

[Abstract] Objective： To investigate the relationship between the clinicopathological features of lung adenocarcinoma and epidermal growth factor （EGFR） gene mutation. Method： A total of 120 patients with lung adenocarcinoma admitted to our hospital from May 2017 to May 2018 were selected as the research objects. Univariate analysis and multiple logistic regression model were used to analyze the relationship between the clinicopathological features of lung adenocarcinoma and EGFR gene mutation. Result： There were 76 EGFR mutations in 120 patients with lung adenocarcinoma. The mutation rates of EGFR gene in male， smoking history and invasive cancer variant were significantly lower than those in female， no smoking history and invasive cancer （P<0.05）. There was no significant difference in the mutation rate of EFGR among different TNM stages and pathological types （P>0.05）. Multiple logistic regression analysis showed that gender， smoking history and tissue subtype were associated with EGFR gene mutation in lung adenocarcinoma （P<0.05）. Among the patients with invasive cancer EGFR gene mutation， acinar type accounted for the highest proportion （56.3%）. Conclusion： EGFR gene mutation is associated with gender， smoking history and histological subtypes in patients with lung adenocarcinoma， and the proportion of acinar type is the highest in patients with invasive cancer EGFR gene mutation.

[Key words] Lung adenocarcinoma EGFR Gene mutation

First-authors address： Ningyang County First Peoples Hospital， Ningyang 271400， China

doi：10.3969/j.issn.1674-4985.2021.11.040

根據2015年我国肿瘤登记年报报道，肺腺癌仍居我国甚至发展中国家的肿瘤发病率、病死率首位[1-3]。肺腺癌属于非小细胞癌，早期一般没有明显的临床症状，大多生长较慢，但有时早期即发生血行转移，淋巴转移则发生较晚。随着精准医学的发展，肺癌的治疗除原有放化疗等方法外，还有基因靶向药物治疗[4-6]。EGFR是原癌基因c-erbB1的表达产物[7]，是表皮生长因子受体（HER）家族成员之一，EGFR基因突变是肺癌研究热点之一[8]，其对细胞的生长、增殖和分化等生理过程发挥着重要的作用。研究表明EGFR表达于正常上皮细胞表面，而在一些肿瘤细胞中常过表达，EGFR的过表达和肿瘤细胞的转移、浸润、预后差有关，主要通过两条信号通路，一条是Ras/Raf/MEK/ERK-MAPK通路，而另一条是PI3K/Akt/mTOR通路[9-10]。以往研究显示肺腺癌临床病理特征与EGFR基因突变存在密切的联系，本研究以分析肺腺癌临床病理特征与EGFR基因突变的关系，进一步指导临床工作。现报道如下。……